tbuckley/cabot-search huggingface dataset:
A Careful Consideration of the Effect of a Decision Aid on Agreement Between Patient Preferences and Repair Type for Abdominal Aortic Aneurysm—Reply
Authors: Mark A. Eid, Philip P. Goodney
Journal: JAMA Surgery (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
It Is Time for the Light to Shine on Organ Procurement Organizations
Authors: Robert M. Cannon, Jayme E. Locke
Journal: JAMA Surgery (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Transparent reporting of multivariable prediction models developed or validated using clustered data: TRIPOD-Cluster checklist
Authors: Thomas P A Debray, Gary S Collins, Richard D Riley, Kym I E Snell, Ben Van Calster, Johannes B Reitsma, Karel G M Moons
Journal: BMJ (2023)

The increasing availability of large combined datasets (or big data), such as those from electronic health records and from individual participant data meta-analyses, provides new opportunities and challenges for researchers developing and validating (including updating) prediction models. These datasets typically include individuals from multiple clusters (such as multiple centres, geographical locations, or different studies). Accounting for clustering is important to avoid misleading conclusions and enables researchers to explore heterogeneity in prediction model performance across multiple centres, regions, or countries, to better tailor or match them to these different clusters, and thus to develop prediction models that are more generalisable. However, this requires prediction model researchers to adopt more specific design, analysis, and reporting methods than standard prediction model studies that do not have any inherent substantial clustering. Therefore, prediction model studies based on clustered data need to be reported differently so that readers can appraise the study methods and findings, further increasing the use and implementation of such prediction models developed or validated from clustered datasets.
Deep learning-based clinical decision support system for gastric neoplasms in real-time endoscopy: development and validation study
Authors: Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Gwang Ho Baik, Hyun Lim, Jae Hoon Jeong, Sung Won Choi, Joonhee Cho, Deok Yeol Kim, Kang Bin Lee, Seung-Il Shin, Dick Sigmund, Byeong In Moon, Sung Chul Park, Sang Hoon Lee, Ki Bae Bang, Dae-Soon Son
Journal: Endoscopy (2023)

BACKGROUND : Deep learning models have previously been established to predict the histopathology and invasion depth of gastric lesions using endoscopic images. This study aimed to establish and validate a deep learning-based clinical decision support system (CDSS) for the automated detection and classification (diagnosis and invasion depth prediction) of gastric neoplasms in real-time endoscopy. METHODS : The same 5017 endoscopic images that were employed to establish previous models were used for the training data. The primary outcomes were: (i) the lesion detection rate for the detection model, and (ii) the lesion classification accuracy for the classification model. For performance validation of the lesion detection model, 2524 real-time procedures were tested in a randomized pilot study. Consecutive patients were allocated either to CDSS-assisted or conventional screening endoscopy. The lesion detection rate was compared between the groups. For performance validation of the lesion classification model, a prospective multicenter external test was conducted using 3976 novel images from five institutions. RESULTS : The lesion detection rate was 95.6 % (internal test). On performance validation, CDSS-assisted endoscopy showed a higher lesion detection rate than conventional screening endoscopy, although statistically not significant (2.0 % vs. 1.3 %; P = 0.21) (randomized study). The lesion classification rate was 89.7 % in the four-class classification (advanced gastric cancer, early gastric cancer, dysplasia, and non-neoplastic) and 89.2 % in the invasion depth prediction (mucosa confined or submucosa invaded; internal test). On performance validation, the CDSS reached 81.5 % accuracy in the four-class classification and 86.4 % accuracy in the binary classification (prospective multicenter external test). CONCLUSIONS : The CDSS demonstrated its potential for real-life clinical application and high performance in terms of lesion detection and classification of detected lesions in the stomach.
Association of Familial Aggregation of Major Depression With Risk of Major Depression
Authors: Frederikke Hørdam Gronemann, Rikke Kart Jacobsen, Marie Kim Wium-Andersen, Martin Balslev Jørgensen, Merete Osler, Terese Sara Høj Jørgensen
Journal: JAMA Psychiatry (2023)

Importance Major depression (MD) aggregates within families, but how family history of MD confers risk of MD over the life course is unclear. Such knowledge is important to identify and prevent possible depressogenic effects of family environment. Objective To examine the association between family MD history and risk of MD including association with age, sex, type of kinship, and age of the affected family member. Design, Setting, and Participants This cohort study included all Danish citizens born from 1960 to 2003 with known parental identity followed up from their 15th birthday until time of MD, censoring, or December 31, 2018. Analysis took place between April 2022 and December 2022. Exposures Family members with first-time MD using International Classification of Diseases, Eighth Revision codes 296.09, 296.29, 298.09, and 300.49 or 10th Revision codes F32.0-F33.9, family members’ age at MD onset, and individuals’ age at exposure to family MD Main Outcomes and Measures Multivariable Poisson regression was applied to estimate the incidence rate ratio (IRR) with 95% CI of first-time MD. Results Of 2 903 430 individuals (1 486 574 [51.2%] men), 37 970 men (2.6%) and 70 223 women (5.0%) developed MD during follow-up. For men, exposure to maternal, paternal, or full sibling MD were associated with a 2-times higher risk of MD (IRR, 2.10 [95% CI, 2.02-2.19]; IRR, 2.04 [95% CI, 1.94-2.14]; IRR, 2.08 [95% CI, 1.97-2.19]) and the associated risk increased with number of affected family members. This pattern was similar for women. For men, family members’ age at MD onset was not associated with MD. For women, maternal MD onset at 69 years or younger was associated with higher IRRs of MD (age &amp;amp;lt;40 years: IRR, 1.64 [95% CI, 1.28-2.10]; age 40-49 years: IRR, 1.62 [95% CI, 1.27-2.07]; age 50-59 years: IRR, 1.56 [95% CI, 1.22-2.00]; and age 60-69 years: IRR, 1.67 [95% CI, 1.28-2.16]) compared with women with maternal MD onset at 70 years or older. For men, exposure to maternal MD younger than 30 years (age &amp;amp;lt;1 year: IRR, 1.95 [95% CI, 1.70-2.25]; age 1 to &amp;amp;lt;12 years: IRR, 2.31 [95% CI, 2.16-2.47]; age 12 to &amp;amp;lt;19 years: IRR, 2.18 [95% CI, 2.03-2.35]; age 19 to &amp;amp;lt;30 years: IRR, 1.42 [95% CI, 1.32-1.53]) was associated with increased IRRs, while exposure to maternal MD at 30 years or older was associated with a lower IRR (0.77 [95% CI, 0.70-0.85]). The findings were similar across type of kinships and for women. Conclusions and Relevance In this study, risk of MD was associated with increased numbers of affected family members but did not vary by gender or type of kinship. Exposure to family MD during childhood and adolescence was associated with increased risk.
Variability in Organ Procurement Organization Performance by Individual Hospital in the United States
Authors: Wali Johnson, Kathryn Kraft, Pranit Chotai, Raymond Lynch, Robert S. Dittus, David Goldberg, Fei Ye, Brianna Doby, Douglas E. Schaubel, Malay B. Shah, Seth J. Karp
Journal: JAMA Surgery (2023)

Importance Availability of organs inadequately addresses the need of patients waiting for a transplant. Objective To estimate the true number of donor patients in the United States and identify inefficiencies in the donation process as a way to guide system improvement. Design, Setting, and Participants A retrospective cross-sectional analysis was performed of organ donation across 13 different hospitals in 2 donor service areas covered by 2 organ procurement organizations (OPOs) in 2017 and 2018 to compare donor potential to actual donors. More than 2000 complete medical records for decedents were reviewed as a sample of nearly 9000 deaths. Data were analyzed from January 1, 2017, to December 31, 2018. Exposure Deaths of causes consistent with donation according to medical record review, ventilated patient referrals, center acceptance practices, and actual deceased donors. Main Outcomes and Measures Potential donors by medical record review vs actual donors and OPO performance at specific hospitals. Results Compared with 242 actual donors, 931 potential donors were identified at these hospitals. This suggests a deceased donor potential of 3.85 times (95% CI, 4.23-5.32) the actual number of donors recovered. There was a surprisingly wide variability in conversion of potential donor patients into actual donors among the hospitals studied, from 0% to 51.0%. One OPO recovered 18.8% of the potential donors, whereas the second recovered 48.2%. The performance of the OPOs was moderately related to referrals of ventilated patients and not related to center acceptance practices. Conclusions and Relevance In this cross-sectional study of hospitals served by 2 OPOs, wide variation was found in the performance of the OPOs, especially at individual hospitals. Addressing this opportunity could greatly increase the organ supply, affirming the importance of recent efforts from the federal government to increase OPO accountability and transparency.
Major Aeroportia Detected on Bedside Ultrasound in a Critically Ill Cardiac Surgery Patient
Authors: Yann Marquet, Edris Omar, Geoffroy Hariri, Adrien Bouglé
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

"Major Aeroportia Detected on Bedside Ultrasound in a Critically Ill Cardiac Surgery Patient." American Journal of Respiratory and Critical Care Medicine, 208(1), pp. e1–e2
Development and Validation of the Morphea Activity Measure in Patients With Pediatric Morphea
Authors: Maria Teresa García-Romero, Megha Tollefson, Elena Pope, Heather A. Brandling-Bennett, Amy S. Paller, Emily Keimig, Lisa Arkin, Karolyn A. Wanat, Stephen R. Humphrey, Victoria P. Werth, Vikash Oza, Heidi Jacobe, Nicole Fett, Kelly M. Cordoro, Isabel Medina-Vera, Yvonne E. Chiu
Journal: JAMA Dermatology (2023)

Morphea is an insidious inflammatory disorder of the skin and deeper tissues. Determining disease activity is challenging yet important to medical decision-making and patient outcomes.
Comparison of Chest Radiograph Captions Based on Natural Language Processing vs Completed by Radiologists
Authors: Yaping Zhang, Mingqian Liu, Lu Zhang, Lingyun Wang, Keke Zhao, Shundong Hu, Xu Chen, Xueqian Xie
Journal: JAMA Network Open (2023)

Importance Artificial intelligence (AI) can interpret abnormal signs in chest radiography (CXR) and generate captions, but a prospective study is needed to examine its practical value. Objective To prospectively compare natural language processing (NLP)-generated CXR captions and the diagnostic findings of radiologists. Design, Setting, and Participants A multicenter diagnostic study was conducted. The training data set included CXR images and reports retrospectively collected from February 1, 2014, to February 28, 2018. The retrospective test data set included consecutive images and reports from April 1 to July 31, 2019. The prospective test data set included consecutive images and reports from May 1 to September 30, 2021. Exposures A bidirectional encoder representation from a transformers model was used to extract language entities and relationships from unstructured CXR reports to establish 23 labels of abnormal signs to train convolutional neural networks. The participants in the prospective test group were randomly assigned to 1 of 3 different caption generation models: a normal template, NLP-generated captions, and rule-based captions based on convolutional neural networks. For each case, a resident drafted the report based on the randomly assigned captions and an experienced radiologist finalized the report blinded to the original captions. A total of 21 residents and 19 radiologists were involved. Main Outcomes and Measures Time to write reports based on different caption generation models. Results The training data set consisted of 74 082 cases (39 254 [53.0%] women; mean [SD] age, 50.0 [17.1] years). In the retrospective (n = 8126; 4345 [53.5%] women; mean [SD] age, 47.9 [15.9] years) and prospective (n = 5091; 2416 [47.5%] women; mean [SD] age, 45.1 [15.6] years) test data sets, the mean (SD) area under the curve of abnormal signs was 0.87 (0.11) in the retrospective data set and 0.84 (0.09) in the prospective data set. The residents’ mean (SD) reporting time using the NLP-generated model was 283 (37) seconds—significantly shorter than the normal template (347 [58] seconds; P &amp;amp;lt; .001) and the rule-based model (296 [46] seconds; P &amp;amp;lt; .001). The NLP-generated captions showed the highest similarity to the final reports with a mean (SD) bilingual evaluation understudy score of 0.69 (0.24)—significantly higher than the normal template (0.37 [0.09]; P &amp;amp;lt; .001) and the rule-based model (0.57 [0.19]; P &amp;amp;lt; .001). Conclusions and Relevance In this diagnostic study of NLP-generated CXR captions, prior information provided by NLP was associated with greater efficiency in the reporting process, while maintaining good consistency with the findings of radiologists.
Minimal invasiveness in lateral bone augmentation with simultaneous implant placement: A systematic review
Authors: Mattia Severi, Leonardo Trombelli, Lisa Heitz‐Mayfield, Roberto Farina, Anna Simonelli
Journal: Periodontology 2000 (2023)

The presence of a peri-implant bone dehiscence (BD) or fenestration (BF) is a common finding after implant placement in a crest with a reduced bucco-lingual bone dimension. The presence of a residual BD is associated with a relevant incidence of peri-implant biological complications over time. Guided bone regeneration (GBR), performed at implant placement, is the most validated treatment to correct a BD. In the present systematic review, the evidence evaluating factors which could reduce the invasiveness of a GBR procedure with respect to patient-reported outcomes, intra- and post- surgical complications, was summarized. Factors included were: technical aspects, regenerative materials for GBR, and peri- and post-operative pharmacological regimens. The available evidence seems to indicate that the use of membrane fixation and flap passivation by means of a double flap incision technique may reduce the incidence of post-surgical complications. When feasible, the coronal advancement of the lingual flap is suggested. The use of a non-cross linked resorbable membrane positively impacts on patient discomfort. The adjunctive use of autogenous bone to a xenograft seems not to improve BD correction, but could increase patient discomfort. Systemic antibiotic administration after a GBR procedure does not seem to be justified in systemically healthy patients.
Bimekizumab efficacy and safety in patients with moderate-to-severe plaque psoriasis who switched from adalimumab, ustekinumab or secukinumab: results from phase III/IIIb trials
Authors: Georgios Kokolakis, Richard B Warren, Bruce Strober, Andrew Blauvelt, Luis Puig, Akimichi Morita, Melinda Gooderham, Andreas Körber, Veerle Vanvoorden, Maggie Wang, Dirk de Cuyper, Cynthia Madden, Natalie Nunez Gomez, Mark Lebwohl
Journal: British Journal of Dermatology (2022)

Abstract Background Discontinuation of biologics is common among patients with psoriasis due to treatment failure or adverse events. To achieve improvements in disease management, patients and clinicians may choose to switch biologics. Objectives To evaluate the efficacy and safety of switching to bimekizumab from adalimumab, ustekinumab and secukinumab. Methods Data are reported for up to 80 weeks after patients switched to bimekizumab from adalimumab at week 24 in BE SURE, ustekinumab at week 52 in BE VIVID [upon entry into the BE BRIGHT open-label extension (OLE)] and secukinumab at week 48 in BE RADIANT (upon entry into the BE RADIANT OLE). Efficacy outcomes are reported by number of weeks after switching to bimekizumab and were split based on whether patients had achieved a ≥ 90% improvement from baseline in Psoriasis Area and Severity Index (PASI 90) at the time of switch. Treatment-emergent adverse events (TEAEs) are reported using exposure-adjusted incidence rates (EAIRs) per 100 patient-years. Trial registration: BE SURE (NCT03412747), BE VIVID (NCT03370133), BE BRIGHT (NCT03598790), BE RADIANT (NCT03536884). Results Rapid and durable improvements in clinical responses and benefits in health-related quality of life were observed among PASI 90 nonresponders who switched to bimekizumab. Most PASI 90 nonresponders achieved PASI 90 4 weeks after switching to bimekizumab from adalimumab (67%), ustekinumab (79%) and secukinumab (53%). After 48 weeks of bimekizumab, 91%, 90% and 79% of PASI 90 nonresponders had achieved PASI 90 after switching from adalimumab, ustekinumab or secukinumab, respectively. Durable improvements were also observed for PASI 100, Investigator’s Global Assessment score 0/1, body surface area affected by psoriasis ≤ 1%, absolute PASI ≤ 2, and Dermatology Life Quality Index 0/1. Among PASI 90 responders, existing treatment responses were maintained or improved after switching to bimekizumab. The majority of TEAEs were mild or moderate. EAIRs were generally similar between active-comparator treatment periods and after switching to bimekizumab. EAIRs typically decreased with a longer duration of bimekizumab exposure. Conclusions High proportions of patients who did not adequately respond to adalimumab, ustekinumab or secukinumab achieved high levels of skin clearance after switching to bimekizumab. Bimekizumab was well tolerated and there were no new safety findings.
Financial Toxicity Among Patients With Breast Cancer Worldwide
Authors: Anam N. Ehsan, Catherine A. Wu, Alexandra Minasian, Tavneet Singh, Michelle Bass, Lydia Pace, Geoffrey C. Ibbotson, Nefti Bempong-Ahun, Andrea Pusic, John W. Scott, Rania A. Mekary, Kavitha Ranganathan
Journal: JAMA Network Open (2023)

Importance Financial toxicity (FT) is the negative impact of cost of care on financial well-being. Patients with breast cancer are at risk for incurring high out-of-pocket costs given the long-term need for multidisciplinary care and expensive treatments. Objective To quantify the FT rate of patients with breast cancer and identify particularly vulnerable patient populations nationally and internationally. Data Sources A systematic review and meta-analysis were conducted. Four databases—Embase, PubMed, Global Index Medicus, and Global Health (EBSCO)—were queried from inception to February 2021. Data analysis was performed from March to December 2022. Study Selection A comprehensive database search was performed for full-text, English-language articles reporting FT among patients with breast cancer. Two independent reviewers conducted study screening and selection; 462 articles underwent full-text review. Data Extraction and Synthesis A standardized data extraction tool was developed and validated by 2 independent authors; study quality was also assessed. Variables assessed included race, income, insurance status, education status, employment, urban or rural status, and cancer stage and treatment. Pooled estimates of FT rates and their 95% CIs were obtained using the random-effects model. Main Outcomes and Measures FT was the primary outcome and was evaluated using quantitative FT measures, including rate of patients experiencing FT, and qualitative FT measures, including patient-reported outcome measures or patient-reported severity and interviews. The rates of patients in high-income, middle-income, and low-income countries who incurred FT according to out-of-pocket cost, income, or patient-reported impact of expenditures during breast cancer diagnosis and treatment were reported as a meta-analysis. Results Of the 11 086 articles retrieved, 34 were included in the study. Most studies were from high-income countries (24 studies), and the rest were from low- and middle-income countries (10 studies). The sample size of included studies ranged from 5 to 2445 people. There was significant heterogeneity in the definition of FT. FT rate was pooled from 18 articles. The pooled FT rate was 35.3% (95% CI, 27.3%-44.4%) in high-income countries and 78.8% (95% CI, 60.4%-90.0%) in low- and middle-income countries. Conclusions and Relevance Substantial FT is associated with breast cancer treatment worldwide. Although the FT rate was higher in low- and middle-income countries, more than 30% of patients in high-income countries also incurred FT. Policies designed to offset the burden of direct medical and nonmedical costs are required to improve the financial health of vulnerable patients with breast cancer.